ArticleBMC cancer2025
PD-1/L1 immune checkpoint inhibitors for KRAS-mutant non-small cell lung cancer: a multicenter retrospective real-world study.
Article in BMC cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- KRAS Mutations as Predictive Biomarkers for First-Line Immune Checkpoint Inhibitor Monotherapy in Advanced NSCLC: A Systematic Review and Meta-Analysis.Current oncology (Toronto, Ont.) · 2025Pooled it
- Integration of hierarchical clustering in hematologic biomarkers prediction for endocrine toxicity during immunotherapy in lung cancer patients.Scientific reports · 2026Article
- Unraveling the nexus: Tumor mutational burden, PD-L1 expression, and oncogenic alterations in non-small cell lung cancer cytology specimens.Cancer cytopathology · 2026Article
- Muscle expression of PD1 and PD-L1 may predict the severity and outcomes of neuromuscular immune-related adverse events caused by immune checkpoint inhibitor treatment.Clinical rheumatology · 2026Article
- Advances in targeting KRAS mutations: A promising approach for the treatment of non‑small cell lung cancer (Review).Oncology reports · 2026Review
- Harmonizing yin and yang, remodeling the microenvironment: the adjuvant potential of Chinese herbal medicine in tumor immunotherapy.Frontiers in oncology · 2026Review
- Neutrophils in non-small cell lung cancer and immunotherapy with PD-1/PD-L1 inhibitors.Journal of translational medicine · 2025Review
- Evaluating the Safety and Efficacy of PD-1 Inhibitors in HIV Patients Diagnosed with Lung Cancer: A Systematic Review.Pharmaceuticals (Basel, Switzerland) · 2025Review
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Authors and funding
6 authors.
Funding
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Abstract
backgroundKRAS (Kirsten rat sarcoma viral oncogene homolog) gene mutation is one of the common driver gene mutations in non-small cell lung cancer (NSCLC) with poor prognosis. There are limited effective treatments for advanced NSCLC patients with KRAS mutation. This study aimed to evaluate the effectiveness of PD-1/L1 immune checkpoint inhibitors (ICIs) as a first-line immunotherapy for advanced NSCLC patients harboring KRAS oncogene mutation.
methodsThis multicenter retrospective real-world study was conducted from 2019 to 2024 at Shanghai Changzheng Hospital and Shanghai Municipal Hospital of Traditional Chinese Medicine, including 78 patients who received immunotherapy using PD-1/L1 ICIs, and 29 patients who received traditional platinum-doublet chemotherapy. The primary endpoints were progression-free survival (PFS) and overall survival (OS). The secondary endpoints included the objective response rate (ORR), disease control rate (DCR), and correlation of prognostic biomarkers with survival outcomes.
resultsNo significant difference in ORR and DCR was observed between the two groups. The median PFS in immunotherapy group was longer than that in chemotherapy group [7.9 months (95% CI: 5.3-10.5) vs. 6.0 months (95% CI: 3.8-8.2), P = 0.030], and there was no significant difference in OS between the two groups (16.2 vs. 19.2 months, P > 0.05). Multivariate analysis identified PD-L1 expression as an independent protective factor for PFS (HR = 0.397, 95% CI: 0.178-0.887, P = 0.024), and elevated CRP (HR = 1.005, 95% CI: 1.001-1.010, P = 0.022), CEA (HR = 1.008, 95% CI: 1.001-1.014, P = 0.030) and neutrophil-to-lymphocyte ratio (NLR) (HR = 1.105, 95% CI: 1.024-1.193, P = 0.010) were independent risk factors for progression.
conclusionThe first-line treatment with PD-1/PD-L1 ICIs showed numerically better clinical efficacy than the traditional double-agent chemotherapy in patients with KRAS-mutated NSCLC, especially in PFS. Additionally, PD-L1 expression, C reactive protein, CEA, and NLR could serve as markers for predicting the efficacy of immunotherapy in patients with KRAS-mutated NSCLC.
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